Objective: To investigate if patients with cervical dystonia (CD) show more subtle deficits in static and dynamic balance as well as learning a whole body balance task.

Background: Cervical dystonia (CD) is characterized by persistent and involuntary head movement, which can lead to an aberrant head posture. Mainly based on neuroimaging studies CD is increasingly considered as a brain network disorder, involving the basal ganglia and sensorimotor cortex areas but also the cerebellum. However, cerebellar functions such as balance and motor learning have never been investigated together in CD patients.

Methods: In this ongoing study, we examined 12 CD patients and 12 age- and sex-matched healthy controls (HC). All participants completed 4 balance training sessions (60 min each) over a period of 2 weeks on a so called “Challenge Disc” that records all body movements. By moving the body’s center of gravity, they had to fix a green dot in a larger, fixed or moving red dot (medium difficulty level, 5 runs of 5 minutes each with a 2 minutes break). The time in which the green dot was hold within the red target region was measured. All participants were tested before (T0) and few days after the training (T1).

Results: No significant differences were found in the static and dynamic balance task between CD patients and the HC group at baseline while using the wilcoxon-test. In the static balance task, CD patients stayed 35±22% in the target compared to 39±20% in the HC group (p = 0.66) and in the dynamic task 24±12% vs. 23±8%, respectively (p = 0.75). Following training similar results were found in both groups (static: 60±22% vs. 65±17%, p=0,75; dynamic: 38±9% vs. 42±7%, p=0,31). Improvement in the static and balance task following training did not differ between both groups.

Conclusions: CD patients did not show any difference neither in the static and dynamic balance task nor in learning a new balance task compared to HC. Our preliminary behavioral data do not support the involvement of the cerebello-thalamo-cortical pathways in CD. However, we speculate that different brain areas are activated in CD in order to compensate for malfunction in the motor network. This will be investigated further in the neuroimaging part of the present study.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-balance-training-in-patients-with-cervical-dystonia/